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I know the possibility of my skin flaring is quite real as I contemplate changing medications. What perplexes me is how to avoid having my psoriasis worsen while giving my kidneys a break from Neoral therapy (cyclosporine). Even better, is there a therapy I haven’t tried yet that could improve my condition without adding any harmful or uncomfortable side effects? I told my dermatologist I would think about what I wanted to do next. Unfortunately, I don’t have any answers yet.

A basic assumption I work under is that the goal of therapy is psoriasis-free skin. When I look at the results of clinical trials, for example, I don’t care too much about those who improved by 50%. I pay more attention to those who improved 75%, 90%, or cleared. Without a doubt I want to be one of those who improve dramatically. I want to clear and stay clear. But is that a proper goal to have?

From an emotional level I long to have that clear skin. If I have that clearing, then maybe I can believe that the psoriasis isn’t even there. At least I can live in that fantasy for a few weeks or months until the psoriasis inevitably returns. While I haven’t achieved clearing much in over the years, I come near to realizing that dream with Enbrel and Neoral. I don’t enjoy being shaken back into reality, that’s for sure. The grim reality is that I need to accept my condition may get much worse for a time no matter what I switch to. In other words, the goal of relatively clear skin must be superseded by a higher goal: to balance the need for relief from psoriasis symptoms with allowing my body to rest from harmful medication side effects.

I’m not entirely certain I am mentally prepared to accept this higher goal for my health. I want to forestall the greater discomfort and anxiety more sores and flaking will bring. But at any cost? What good is it if my kidneys sustain damage for the sake of having relatively clear skin? I still don’t know what to do next, but my options open up a bit if I’m willing to suffer. I think I will be willing to if there is a higher purpose to it, but I Just need a little more time to come to that place of acceptance.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health. See More

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